II 

112TH CONGRESS 

1ST SESSION S. 756 

To amend title XI of the Social Security Act to provide for the public 

availability of Medicare claims data. 

IN THE SENATE OF THE UNITED STATES 

APRIL 7 (legislative day, APRIL 5), 2011 

Mr. GRASSLEY (for himself and Mr. WYDEN) introduced the following bill; 

which was read twice and referred to the Committee on Finance 

A BILL 

To amend title XI of the Social Security Act to provide 

for the public availability of Medicare claims data. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Medicare Data Access 

5 for Transparency and Accountability Act’’. 

6 SEC. 2. PUBLIC AVAILABILITY OF MEDICARE CLAIMS DATA. 

7 (a) IN GENERAL.—Section 1128J of the Social Secu8 rity Act (42 U.S.C. 1320a–7k) is amended by adding at 

9 the end the following new subsection: 


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1 ‘‘(f) PUBLIC AVAILABILITY OF MEDICARE CLAIMS

2 DATA.— 

3 ‘‘(1) IN GENERAL.—The Secretary shall, to the 

4 extent consistent with applicable information, pri5 vacy, security, and disclosure laws, including the 

6 regulations promulgated under the Health Insurance 

7 Portability and Accountability Act of 1996 and sec8 tion 552a of title 5, United States Code, make avail9 able to the public claims and payment data of the 

10 Department of Health and Human Services related 

11 to title XVIII, including data on payments made to 

12 any provider of services or supplier under such title. 

13 ‘‘(2) IMPLEMENTATION.— 

14 ‘‘(A) IN GENERAL.—Not later than De15 cember 31, 2012, the Secretary shall promul16 gate regulations to carry out this subsection. 

17 ‘‘(B) REQUIREMENTS.—The regulations 

18 promulgated under subparagraph (A) shall en19 sure that— 

20 ‘‘(i) the data described in paragraph 

21 (1) is made available to the public through 

22 a searchable database that the public can 

23 access at no cost; 

24 ‘‘(ii) such database— 


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1 ‘‘(I) includes the amount paid to 

2 each provider of services or supplier 

3 under title XVIII, the items or serv4 ices for which such payment was 

5 made, and the location of the provider 

6 of services or supplier; 

7 ‘‘(II) is organized based on the 

8 specialty or the type of provider of 

9 services or supplier involved; 

10 ‘‘(III) is searchable based on the 

11 type of items or services furnished; 

12 and 

13 ‘‘(IV) includes a disclaimer that 

14 the aggregate data in the database 

15 does not reflect on the quality of the 

16 items or services furnished or of the 

17 provider of services or supplier who 

18 furnished the items or services; and 

19 ‘‘(iii) each provider of services or sup20 plier in the database is identified by a 

21 unique identifier that is available to the 

22 public (such as the National Provider Iden23 tifier of the provider of services or sup24 plier). 


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1 ‘‘(C) SCOPE OF DATA.—The database shall 

2 include data for fiscal year 2012, and each year 

3 fiscal year thereafter.’’. 

4 (b) INFORMATION NOT EXEMPT UNDER THE FREE5 DOM OF INFORMATION ACT.—The term ‘‘personnel and 

6 medical files and similar files the disclosure of which 

7 would constitute a clearly unwarranted invasion of per8 sonal privacy’’, as used in section 552(b)(6) of title 5, 

9 United States Code, does not include the information re10 quired to be made available to the public under section 

11 1128J(f) of the Social Security Act, as added by sub12 section (a). 

Æ 


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